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Dr. Bonnie Jones: Does your pet need a cane?


August 24. 2013 12:26PM
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Veterinarians are commonly presented pets for evaluation of a limp, and after a thorough orthopedic exam, the cause can usually be readily identified. Sedation and X-rays are sometimes necessary, especially for the pet that exhibits extreme pain or anxiety during manipulations.



Pet owners often express that they donít think their limping pet is in pain because it doesnít cry or wince when examined at home. My response is always "a limp equals pain" since the pet chooses not to bear full weight on the limb (because it hurts!). Unlike humans who are very vocal about what hurts and precisely where, veterinarians have to be "trained investigators" to diagnose the source of a limping petís discomfort.



To evaluate the limping pet, I first determine how extreme the limp is to prioritize the most likely causes. A good rule of thumb is to assess the foot first in a pet that will not bear weight on a limb at all, as more painful orthopedic problems often involve this area. If your pet has a foot laceration, toe tumor, torn toenail, or broken toe, you may expect that it will have a significant and obvious limp.



While examining a petís foot, I am careful to run my fingers over every digit and toenail to look for wounds, foreign bodies (e.g. thorns, stingers), and swellings. Both sides of the foot need to be thoroughly examined to avoid overlooking common skin infections on the underside of the feet of allergic pets.



Once I am convinced that the foot is not showing abnormalities or pain, I proceed up the petís limb, carefully palpating and visualizing every surface and bone of the limb. Each joint in the leg is taken through range of motion exercises to determine if there is a restriction or pain response from the pet. For front limbs, the shoulder joint and shoulder blade need to be evaluated. The rear leg examination includes assessment of the hip joints and lower spine.



After I have identified the anatomical location of the pain, I then consider what the most likely diagnoses would be based on the patient, its lifestyle, overall health, and the pet ownerís history of events. Veterinarians know that overweight pets are more prone to orthopedic injuries, small breed dogs are more inclined to have congenital knee defects (patellar luxation), large breed dogs are more likely to be born with hip dysplasia and develop osteoarthritis, and outdoor cats get in fights that can result in painful limb abscesses.



Besides frequently diagnosing osteoarthritis and congenital joint defects, the more common orthopedic problems detected in dogs include torn cranial cruciate ligaments in knees and bone cancer. Ligament injuries are common in active and overweight dogs and usually result in a non-weight bearing limp in the hind leg. This injury is best treated with surgical correction, but is often addressed medically as well.



Bone cancers, known as osteosarcoma, are most likely to occur in large breed dogs including Rottweilers, Golden and Labrador Retrievers and St. Bernards. These tumors are diagnosed on X-rays by their typical destruction of the integrity of the long bones near the shoulder or around the knee. Pets with osteosarcoma will experience intense discomfort that is often non-responsive to commonly prescribed anti-inflammatory medications. Treatment for osteosarcoma includes limb amputation, followed by chemotherapy.



For very young pets, especially puppies that have been dropped or stepped on, there can be a loud and immediate expression of pain. Keep in mind that they are "babies," and, fortunately, as quickly as young pets get injured, they can return to normal and forget anything ever happened. Thus, I often recommend crating a young, limping pet for 15 to 30 minutes, then re-evaluate the limp. Often the problem will entirely resolve on its own during this short time period.



If your pet is unfortunate enough to fracture a limb, please remember your basic first aid. Immediately apply clean, pressure dressings to bleeding wounds. Stabilize fracture sites with a homemade splint made from rolled up newspaper, wood, or PVC pipe (cut in half length wise) applied to the back of the limb and secured with bandage material. Know your veterinarianís after hours emergency policies and contact numbers before an emergency occurs. Listen carefully and follow all instructions when being advised to seek emergency veterinary attention.



Donít let your injured or limping pet suffer needlessly. If your petís limp persists for more than 24 hours, seek the advice of your veterinarian. With early diagnosis and treatment, your pet will be restored to health more quickly and you will minimize the risk for lifelong changes including painful osteoarthritis.








Dr. Bonnie Jones: Does your pet need a cane?


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